<p> Steps to Become an Alcohol and Drug Evaluation Services Provider *For new “Treatment Programs” providing Alcohol and Drug services, you must first be licensed by the State, Kansas Department for Aging and Disability Services/Behavior Health Services (KDADS/BHS). Go to http://www.kdads.ks.gov/AAPS/Licensing/Facility_Licensing.html or (kdads.ks.gov, Behavioral Health Services, Providers, Licensing Certification, Substance Use disorder Treatment) and fill out the application for licensure. After licensed by the KDADS/BHS, you can request the utilization of the KCPC for Alcohol and Drug Evaluation Services. After receiving your program license, the following are the procedures for Alcohol and Drug Evaluation services and the KCPC access. Also see “For All”</p><p>*For new “Individuals” (These are individuals not working in a licensed program)Go to http://www.kdads.ks.gov/AAPS/Licensing/Facility_Licensing.html or (kdads.ks.gov, Behavioral Health Services, Providers, Licensing Certification, Alcohol and Drug Evaluator Certification) and fill out the application for Alcohol and Drug Evaluations. Submit this application as it states to KDADS/BHS-Billie Fuller. Also see “For All” </p><p>*For existing programs licensed by KDADS/BHS, if you want to add Alcohol and Drug evaluation services to your program please fill out the Modality Supplemental Application from our website and mark Alcohol and Drug evaluation services. http://www.kansasbehavioralhealthservices.org/Bhs1.0/Providers/Licensing_Certification/Substance_Use_Disor der_SUD_Treatment_Facilities.aspx or (kdads.ks.gov, Behavioral Health Services, Providers, Licensing Certification, Substance Use disorder Treatment) Fill out Attestations for each person using the KCPC for A&D evals. Provide the following for each A&D evaluator for the directory.</p><p>First Name Last Name Program if County City Address Phone Email Languages applicable Avail </p><p>Send this to Billie Fuller at [email protected] . Also see “For All”</p><p>For All The process to add Alcohol and Drug evaluation services requires the program to utilize the KCPC as the standardized assessment tool, therefore we require forms for computer specifications and security filled out and submitted. Below is our process:</p><p>*Submit the security forms (shown in pictures below) located at the KDADS website http://www.kdads.ks.gov/ </p><p>*Click on “Provider Information” link within the top navigation bar, Click on the padlock icon at the bottom of the menu listing that says “KDADS Web Application Access Security Agreement”.</p><p>*Where there is an arrow ( ), there is information to be filled out. Steps to Become an Alcohol and Drug Evaluation Services Provider</p><p>Continued on next page</p><p>1. Once these forms are approved, you will receive a letter from Behavioral Health Services (BHS) that allows you to complete the installation of the KCPC.</p><p>2. Please go to the following website to take a web based KCPC training to help you through the process of completing the KCPC. http://www.kdads.ks.gov/CSP/AAPS_Training.html or (kdads.ks.gov, Provider information, KDADS Web Application information, Public Exam & Survey Center, Web Based Training Courses, KCPC Technical Training) </p><p>3. If you have any questions about this process or the approval of the security forms, please contact KDADS Helpdesk at 785-296-4987.</p><p>4. If you have questions about the “technical” part of the Training, Please call Deby Zimmerman at 785- 296-6459.</p><p>5. If you have “clinical” questions, please call either your KDADS program consultant or Central Office at 785-296-6807.</p>